Review of the Knowledge, Barriers, and Facilitators of HPV Vaccination among Latino Migrant and Seasonal Farmworkers in the United States.

One subgroup of Latinos whose healthcare needs must be more thoroughly addressed is the roughly three million farmworkers pursuing seasonal agricultural work within the United States (U.S.). Latino migrant and seasonal farmworkers (MSFW) face compounded political, social, and personal contexts that complicate healthcare access. Although the human papillomavirus (HPV) vaccine prevents HPV infections and cancers, uptake among Hispanic adolescents remains suboptimal. Therefore, it is important to understand Latino MSFW's HPV knowledge, as well as barriers to and facilitators of vaccination so culturally appropriate measures can bolster vaccination. An integrative review was conducted in PubMed, Scopus, and Web of Science using key search terms. Results were evaluated for compatibility with inclusion/exclusion criteria, and selected articles were coded and evaluated via thematic analysis. Six studies of various designs were ultimately included in the review. While some Latino MSFW have baseline knowledge about HPV and the vaccine, knowledge gaps remain. Participants expressed curiosity about how the vaccine works, contents, side effects, dosing, recommended age, and information about prevented diseases. Although additional education and MSFW's receptiveness to provider's recommendations were cited as major facilitators, many barriers also need addressed. Providers must leverage MSFW's existing knowledge, provide education, and facilitate vaccination to protect farmworker families from HPV and related cancers. It must become standard practice for providers to recommend the HPV vaccine to MSFW, who are receptive to this conversation. Increasing vaccination can decrease the disproportionate burden of HPV-related cancers on patients and facilitate access to healthcare services.

Reclaiming the mission of academic medicine: An examination of institutional responses to (anti)racism.

PURPOSE: The utility of institutional statements is said to provide clarity and reinforcement of an institution's goal. Unfortunately, it can also be argued that these statements are in clear misalignment between the words described and the environments that faculty, students, trainees, and staff of color face. The purpose of this study was to analyze academic medicine institutional statements that responded to 2020 racial tensions following the murders of George Floyd, among others, and the subsequent nationwide protests against police brutality. METHODS: We conducted a manifest content analysis of institutional statements generated by academic medical centers after George Floyd's murder. We used manifest content analysis to gain insights into how institutional statements connect structural racism to the mission of academic medicine. We collected and examined institutional statements from 26 academic medicine centers. Selection parameters included statements that were publicly available and published by the institutions during a 2-week period. We conducted a four-stage analysis: decontextualization, recontextualization, categorization, and compilation. To better understand the collection of statements, we plotted these institutional statements according to the most salient discussed themes. RESULTS: Overall, institutional statements discussed racism through three subthemes: identifying the racial implications of health disparities, issuing a call to action to address racism, and decentering race. Absent language is also noted. Second, institutional statements evoked institutional values by expressing an explicit connection with the academic medicine mission, naming the value of social justice, and emphasizing the concept of community. Finally, institutional statements largely discussed public health in connection with racism or with institutional values. CONCLUSION: Our study determines a much-needed reconnection to the mission of academic medicine. Reclaiming the social mission will be a major step toward recentering the foundation of institutional actions. This call is what ultimately will improve the health and well-being of marginalized populations.

A Critical Examination of Community Engagement as a Practice to Foster Leadership.

The authors of this chapter describe how leadership educators can create community engagement experiences to foster student leadership. The authors center social justice, critical race theory, and trauma informed practices in order to advocate for justice and equity with communities and students.